55 WARREN ST - BUILDING INSPECTION (2) o ,.a
II �z, The Commonwealth of Massachusetts
n;+ , Board of Building Regulations and Standards CITY OF
Massachusetts State Building Code, 780 CMR SALEM
Revised Mar 2011
Building Permit Application To Construct, Repair, Renovate Or Demolish a
One-or Two-Family Divelling
This Se on qor Official jJse Only
Building Permit Number: ate plied:
Building Official(Print Name) Signati Date
SEC ON 1:SITE INFORMATION
1.1 Pro e y Address: 1.2 Assessors Map& Parcel Numbers
1.la Is this an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq fl) Frontage(tl)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public❑ Private❑ Zone: _ Outside Flood Zone?Check if yes[] Municipal ❑ On site disposal system El
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner of Recor
dl )rz ,�)oAZK */e Vq—(-)I-�?J
Name(Print) City.S�-���
No.and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ElRepairs(s) ❑ Alteration(s) ❑ Addition ❑
Demolition ❑ Accessory Bldg. ❑ Number of Units Other ❑ Specify:
Brief Description of Proposed Work':
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs:
Labor and Materials Official Use Only
1. Building $ 1. Building Permit Fee:$ Indicate how fee is determined:
2. Electrical $ ❑Standard City/Town Application Fee
❑Total Project Cost'(Item 6)x multiplier x
3. Plumbing S 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire $ ,
Suppression) Total All Fees:$
Check No. Check Amount: Cash Amount:
6.Total Project Cost: $ 0 Paid in Full 0 Outstanding Balance Due:
e
SECTION 5: CONSTRUCTION SERVICES
5.1 tion Supervisor License(CSL)
struc
CK+ fjU,� License Number Esp ratio ate /
Name of CSL Holder
� List CSL Type(see below)�A
�l)"'��
No. and Street Type Description
/ram J U Unrestricted2 Family
(Buildings u el ing cu. RJ
/� {f R Restricted I&2 Pmnil Dwelling
City/Down,st�e,ZIP ,I M Mason
ry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
tK I Insulation
Tele hone l — Email address D Demolition
5.2 Registered Home Improvement Contra r(HIC) / 5!
`` +
>
(-Al,) ytk �a�}p_�6L>� HIC Registration Number JExpvaAon —at e
HIC t �nv-Nanic o IIC Regis[.nt Nan
No.and �e [ 4f?—)
Email address
City/Town, State,ZIP Telephone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.§ 25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide
this affidavit will result in the denial of the Iss ance of the building permit.
Signed Affidavit Attached? Yes .......... No ........... ❑
SECTION 7a:OWNERAVTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1,as Owner of the subject property,hereby authorize
to act on my behalf,in all matters relative to work authorized by this building permit application.
Print Owner's Name(Electronic Signature) Dale
SECTION 7b: OWNEW OR AUTHORIZED AGENT DECLARATION
By entering my name below, I hereby attest under the pains and penalties of perjury that all of the information
contained ' his application is true and accurate to the best of my knowledge and understanding.
/�� l�
/�►�) I l�itk)t� ,�_
Pnnt Owner's or Aulh zed Agent's Name(Electronic S�gnatu Date
NOTES:
1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(HIC)Program), will not have access to the arbitration
program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at
%vww.mass.-,ov'oca Information on the Construction Supervisor License can be found at wwwv.niass.,ov'dns
2. When substantial work is planned,provide the information below:
Total Floor area(sq. ft.) (including garage, finished basement/attics,decks or porch)
Gross living area(sq. ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"• '
" MI
J
2 WASHINGTON ST.#256
PRESERVE 6.2 SALEM, MA 01970
IV- IF
carpentry)painting)r oFingl gutters 11 PHONE:978.745.8745
SERVICES �b FAx:978.7 ES.COM
SALES@ PRESERVESERV ICES.COM
I !r$ wNYk
Rick J� 0 Yup-StEstimator:
id:12/6/2010
55 Warren SY Sean O'Connor
Salem MA, 01970
(617) 831-7652
ROOFING ESTIMATE
COMMENTS The below estimate is for the Fentire upper roof minus the south slopping upper section.
Exclude the flat roof on the rear; sunporch roand the copper roof above the front entrance.
PRIOR PREPARATION
PERMITTING: All permits will be obtained in accordance with the law as required.
DISPOSAL: A dumpster will be placed in a area designated by the homeowner.
ROOFING PREPARATION
COVERING: Tarp the exterior of the house so as not to damage the siding.
SHINGLE REMOVAL: Remove all layer(s) of old shingles
NAILING: Re-nail roof decking as necessary.
UNDERLAYMENT
FELT: Install 15 lb felt on all areas not covered by ice and water shield.
ICE AND WATER SHIELD: Install 3 feet of ice and water shield on eves and valleys. Install as
necessary on other areas.
FLASHING
DRIP EDGE: Install drip edge on all perimeters.
WALL JUNCTION: Install or rework flashing where the roof meets the wall.
VENT PIPES: Install new boot or flange around vent pipes.
CHIMNEY(S): Install or rework the flashing around all chimney(s).
e �
VENTILATION
RIDGE VENT: Install ridge vents.
ROOFING MATERIALS
ASPHAULT SHINGLES: Install 3 tab shingle 25 year.
PRICING
Basic $ 5250
Discount $ -525
Total Price $ 4725 including Labor &Material
Payment Terms: 20% deposit (day of start); 30%progress; 5014 end of j b cNisa/Amex
Sean O'Connor Customer SiCg)nati re
ADDITIONAL TO ABOVE ESTIMATE:
BID 1: Rear lower flat roof. s tk b6w/ 6 `
Price $ 695 Including Labor and Material 6 ' !
*Above additional prices includes all discounts and coupons discussed prior to estimate. The
above quote is valid for 60 days.
*Warranty: Craftsmanship: Kyron Inc. DBA Preserve Services warrantees all work performed
for a period of 2 years. If any problems occur we will cover the cost of labor and materials. For the
warranty to be valid the invoice that was presented at the time of completion must have been paid in full.
Materials: The duration of the manufacture's warranty is specified in the materials section above.
Licenses:
Home Improvement Contractor(HIC): 123553
Protection: It is required by law that roofing contractors have a home improvement contractor
license. If a contractor is properly registered, you are entitled to limited protection by the
Residential Contractor Guaranty Fund up to $10,000. (The above is a only a summary of
Massachusetts General Law 142A) To check our license or our competitors go to:
http://db.state.ma.us/homeimprovement/licenseelist.asp and license 123553.
Constructor Supervisor(CS): 93403
The construction Supervisors license is under an individual's name,not a company name. To
Week Sean O'Connor, owner of the Kyron Inc. DBA Preserve, license go to:
hl!p:Hdb.state.ma.us/dps/licenseelist.asi) select Construction Supervisor and license 93403.
Insurance:
Worker's Compensation:
Our policy is under Kyron Inc. DBA Preserve Services
Protection: Covers the injury of a worker employed by the contractor doing work at your home.
To check our policy or our completions go to http://mass. ove /dia/ on this page go to"check
worker's compensation proof of coverage"our license is under Kyron Inc.
Liability Insurance
Our policy is under Kyron Inc. DBA Preserve Services and has limit of$1,000,000.
Protection: Covers your property in the event of accidental damage up to a dollar limit specified
on the policy. To check our policy we will have to contact our insurance company.
�0�1•
Salem Historical Commission
120 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970
(978) 619-5685 FAX(978)740-0404
CERTIFICATE OF NON-APPLICABILITY
It is hereby certified that the Salem Historical Commission has determined that the proposed:
Construction ❑ Moving
Reconstruction ❑ Alteration
❑ Demolition ❑ Painting
❑ Signage ❑ Other Work
as described below does not involve an exterior architectural feature or involves a feature covered by the
exemptions or limitations set forth in the Historic District's Act(M.G.L. Ch. 40C) and the Salem Historic
Districts Ordinance.
District: McIntire
Address of Property: 55 Warren Street
Name of Record Owner: Richard .Tons & Naomi Cottrell
Description of Work Proposed:
Replacement of existing black, 3 tab asphalt roof with new black, 3-tab asphalt roof No changes in color,
material, design, location or outward appearance. Non-applicable due to being in kind
maintenance/replacement.
Dated: May 3 2011 SAL AL COMMISSION'
B
w .....
The homeowner, mhas the option not-to.commence the-work(unless ifr6fates to resolving an outstanding
violation). All work comenced must be completed within one year from this date unless otherwise,indi.
THIS IS NOT A BUILDING PERMIT. Please be sure to obtain the appropriate permits from the Inspector of
Buildings (or any other necessary permits or approvals) prior to commencing work.
CITY OF SM.&MIO IL-SSACHUSETI'S
• BLILDLNG DEPARTMENT
120 WASHINGTON STREET, P FLOOR
TEL (978) 745-9595
FAx(978) 740-9846
K1.,%fBERLEY DR.ISCOLL
MAYORIHO.WS ST.PIERRB
DIRECTOR OF PUBLIC PROPERTY/BUILDING COMMISSIONER
Construction Debris Disposal Affldavit
(required for all demolition and renovation work)
In accordance with the sixth edition of the State Building Code, 780 CMR section l l 1.5
Debris, and the provisions of MGL c 40, S 54;
Building Permit # is issued with the condition that the debris resulting from
Ns work shall be disposed of in a properly licensed waste disposal facility as defined by MGL c
111, S 150A.
The debris will be transported by:
Ea, &oys.4( .
(name of hauler)
The debris will be disposed of in
(name of facility)
(address of facility)
signature permit applicant
ate
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